糖化血红蛋白水平与急性冠状动脉综合征患者的动脉粥样硬化严重程度无关。
Hemoglobin A1c Level Is Not Related to the Severity of Atherosclerosis in Patients with Acute Coronary Syndrome.
作者信息
Wang Xinhong, Han Zhenhua, Hao Guanghua, Li Yongqin, Dong Xin, Wang Congxia
机构信息
Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
出版信息
Dis Markers. 2015;2015:192108. doi: 10.1155/2015/192108. Epub 2015 Jul 16.
BACKGROUND
The relationship between hemoglobin A1c (HbA1c) levels and the extent of coronary artery stenosis in patients with acute coronary syndrome (ACS) remains uncertain. The present study aimed to assess the correlation of HbA1c level with angiographic coronary atherosclerosis.
METHODS
292 consecutive ACS patients were enrolled and stratified into three groups according to HbA1c levels (group 1: < 6.0%, n = 137; group 2: 6.0-6.4%, n = 67; group 3: ≥ 6.5%, n = 88). The severity of coronary arteriosclerosis was assessed by Gensini score. The relationship between HbA1c and Gensini score was analyzed by multiple variables analysis.
RESULTS
HbA1c level was not associated with the severity of CAD assessed by Gensini score in patients with ACS, even after the adjustment for other risk factors. However, NT-proBNP, ApoA1 and LVEF levels were independent predictors for CAD severity. Moreover, HbA1c level was not associated with the risk of high Gensini score (> 40) by logistic regression analysis. Diabetes mellitus (DM) and LVEF levels were two independent risk factors for high Gensini score.
CONCLUSIONS
HbA1c level is not a significant and independent marker for the severity of angiography in ACS patients, even in high-risk patients.
背景
急性冠状动脉综合征（ACS）患者中糖化血红蛋白A1c（HbA1c）水平与冠状动脉狭窄程度之间的关系仍不明确。本研究旨在评估HbA1c水平与冠状动脉造影动脉粥样硬化的相关性。
方法
连续纳入292例ACS患者，并根据HbA1c水平分为三组（1组：<6.0%，n = 137；2组：6.0 - 6.4%，n = 67；3组：≥6.5%，n = 88）。通过Gensini评分评估冠状动脉粥样硬化的严重程度。采用多变量分析方法分析HbA1c与Gensini评分之间的关系。
结果
即使在对其他危险因素进行校正后，ACS患者中HbA1c水平与通过Gensini评分评估的CAD严重程度无关。然而，NT - proBNP、载脂蛋白A1和左心室射血分数（LVEF）水平是CAD严重程度的独立预测因素。此外，通过逻辑回归分析，HbA1c水平与高Gensini评分（>40）风险无关。糖尿病（DM）和LVEF水平是高Gensini评分的两个独立危险因素。
结论
即使在高危患者中，HbA1c水平也不是ACS患者血管造影严重程度的重要独立标志物。
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